Healthcare Provider Details

I. General information

NPI: 1477470524
Provider Name (Legal Business Name): ROCHELLE ELANA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N EUTAW ST STE 101
BALTIMORE MD
21201-6301
US

IV. Provider business mailing address

821 N EUTAW ST STE 101
BALTIMORE MD
21201-6301
US

V. Phone/Fax

Practice location:
  • Phone: 410-779-3682
  • Fax:
Mailing address:
  • Phone: 410-779-3682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT-4102
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: